Laura Davidson, NP | NPI 1003105073

Key facts

NPI: 1003105073
Entity type: Individual (NPI type 1)
Primary specialty: Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License: APRN02027 (RI)
Practice address: 65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone: (401) 785-0040
Fax: (401) 633-6253
NPI assigned: Mar 30, 2011
Sex: Female
Sole proprietor: No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Child and Family Psychiatry, Inc. Psychiatry Physician · Warwick, RI · NPI 1760863229

Medicare reassignment Care Compare group NPD RI
Thundermist Health Center Federally Qualified Health Center (FQHC) · Wakefield, RI · NPI 1700041001

Medicare reassignment NPD RI
Thundermist Health Center Federally Qualified Health Center (FQHC) · Narragansett, RI · NPI 1265190292

NPD

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2013
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services
Group practices: Child and Family Psychiatry, Inc. (90 clinicians)

Practice addresses (Care Compare)

65 Village Square Dr
Suite 302
South Kingstown, RI 02879-2569
Phone (401) 785-0040

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in RI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20190426001505	RI	Practitioner - Certified Clinical Nurse Specialist (CNS)	5193902971	Reassigns benefits to 1 organization
I20240701003908	RI	Practitioner - Nurse Practitioner	5193902971	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
APRN02027	RI	MD	Psychiatric/Mental Health Nurse Practitioner

Practice roles

Organization	Status	New patients
Thundermist Health Center	Current since Apr 1, 2019	Accepting new patients
Thundermist Health Center	Current since Apr 1, 2019	Accepting new patients
Child and Family Psychiatry, Inc.	Current since Jun 1, 2024	Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

65 Village Square Dr
Ste 302
South Kingstown, RI 02879
Phone (844) 754-6564

1 River St
Wakefield, RI 02879
Phone (401) 783-0523

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

450 Clinton St
Woonsocket, RI 02895

Interoperability endpoints

Direct secure messaging: lifestancehealth.lauradavidson@151046.advancedmd-direct.com
FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	APRN02027	RI	Yes

Addresses

Primary practice location

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569

Mailing address

65 Village Square Dr Ste 302
South Kingstown, RI 02879-2569
Phone (401) 785-0040

Other providers in South Kingstown, RI

All providers in South Kingstown, RI · Psychiatric/Mental Health Nurse Practitioner in Rhode Island

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.